| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SERVCO INSURANCE SERVICES CORP3 Filed as: SERVCO INSURANCE SERVICES CORP. | 700 BISHOP STREET, 14TH FLOOR HONOLULU, HI 96813 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $6K | — | $6K | 3.54% |
| SERVCO INSURANCE SERVICES CORP3 Filed as: SERVCO EMPLOYEE BENEFITS CONSULTING | 700 BISHOP STREET, SUITE 1400 HONOLULU, HI 96813 | HAWAII DENTAL SERVICE | $3K | — | $3K | 2.50% |
| ANDREW D. GILMOUR, INC.3 Filed as: ANDREW GILMOUR | 300 W GLENOAKS BLVD STE 301 GLENDALE, CA 91202 | HEALTH PLAN OF NEVADA/SIERRA HEALTH & LIFE | $2K | — | $2K | 4.73% |
| SERVCO INSURANCE SERVICES CORP3 | 700 BISHOP STREET 14TH FLOOR HONOLULU, HI 96813 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 12.64% |
| SERVCO INSURANCE SERVICES CORP3 | 700 BISHOP STREET 14TH FLOOR HONOLULU, HI 96813 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| SERVCO INSURANCE SERVICES CORP3 | 700 BISHOP STREET 14TH FLOOR HONOLULU, HI 96813 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $433 | — | $433 | 14.98% |
| SERVCO INSURANCE SERVICES CORP3 | 700 BISHOP STREET 14TH FLOOR HONOLULU, HI 96813 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $419 | — | $419 | 15.00% |
| ANDREW D. GILMOUR, INC.3 Filed as: ANDREW GILMOUR | 300 W GLENOAKS BLVD STE 301 GLENDALE, CA 91202 | UNION SECURITY INSURANCE COMPANY | $58 | — | $58 | 5.69% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 145 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 147 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 286 | $1.2M |
| Dental | HAWAII DENTAL SERVICE | 290 | $107K |
| Vision(3 contracts, 3 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 286 | $1.1M |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 136 | $31K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 27 | $8K |
| Prescription drug(3 contracts, 3 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 286 | $1.2M |
| Other(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 136 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 290 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.